Blue Shield 65 Plus (HMO) in Santa Barbara County, California — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
Blue Shield 65 Plus (HMO) (H0504-039) is a $65-premium Medicare Advantage HMO from California Physicians' Service available in Santa Barbara County, California in 2026, with a 4.0-star overall rating, a $4,100 in-network out-of-pocket maximum, and a $425 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | California Physicians' Service |
|---|---|
| Plan name | Blue Shield 65 Plus (HMO) |
| Contract ID | H0504 |
| Plan ID | 039 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA-PD |
| Plan type | HMO |
| SNP | No |
| Monthly consolidated premium | $65.00 |
| Part C premium | $65.00 |
| Part D basic premium | $16.50 |
| Part D total premium | $0.00 |
| Annual Part D deductible | $425.00 |
| Maximum out-of-pocket (in-network) | $4100.00 |
| Overall star rating | 4.0 |
How this plan is structured
- $65 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- HMO plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
- $4,100 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Santa Barbara County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Santa Barbara County
The CMS CY2026 Landscape file lists 9 Medicare Advantage plans in Santa Barbara County, California, of which 0 carry a 5.0-star overall rating and 4 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $120.00 per month, and in-network out-of-pocket maximums range from $296.00 to $9250.00.
For the full county plan directory, see all Medicare plans in Santa Barbara County, California.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H0504-039.
- Call the plan (California Physicians' Service) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H0504-039 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H0504-039, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 0504 are the contract number issued to the organization, and the three-digit 039 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is Blue Shield 65 Plus (HMO) an HMO or PPO?
Blue Shield 65 Plus (HMO) is an HMO — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.
Does Blue Shield 65 Plus (HMO) include prescription drug coverage?
Yes — Blue Shield 65 Plus (HMO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $425.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for Blue Shield 65 Plus (HMO)?
The 2026 in-network maximum out-of-pocket limit for Blue Shield 65 Plus (HMO) is $4100.00, per the CMS CY2026 Landscape file.
What counties offer Blue Shield 65 Plus (HMO) (H0504-039)?
Blue Shield 65 Plus (HMO) (H0504-039) is offered in two California counties: San Luis Obispo County and Santa Barbara County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.